Is it depression, or just sadness?

Thursday, September 10, 2009

By STACEY SOLT TN Correspondent tneditor@tnonline.com

One of the most common questions Dr. Farhad Sholevar hears is, "What is the difference between sadness and depression?" Sholevar is chief of the Psychiatry Division and the Older Adult Behavioral Health Center at Blue Mountain Health System.

Depression is a serious medical problem that can be treated. Sadness is a normal, natural human emotion. In other words, you may be sad if you lose your job but you likely aren't depressed.

"They may be very sad and even cry, but this is not depression," he said. "That's simple unhappiness. It is very important to distinguish between these two things."

Depression is caused by a chemical imbalance in the brain, and neurotransmitters that affect mood and emotions can lead to symptoms of depression such as tiredness, lack of interest in favorite hobbies, and constant sadness. Depression is typically treated with medication that can correct this imbalance.

Sadness is often caused by difficult situations, such as a job loss or being in a bad relationship. Anti-depressants will not help unhappiness caused by situational problems, stressed Sholevar.

While the symptoms of "situational sadness" and depression are often similar, they are treated differently. Most doctors will also take into account how you are handling the situation. Are you talking about your problems, or pretending that they do not exist? Are you able to deal with the details of everyday life and take care of yourself and family members?

If you are continuing your life but experience unhappiness, you may not be experiencing depression.

"You are dealing with a very difficult situation," he said. "You're showing a normal response to this situation."

Instead of turning to medications, Sholevar encourages area doctors to guide their patients toward psychotherapy (talk therapy) with a counselor or psychologist. People suffering from sadness should also remove themselves from the problem when possible. For example, end a bad relationship, or find an alternative job if a current career is causing stress and unhappiness.

Crying is a natural response to stress and sadness, said Sholevar. While many people associate crying with depression, he compares crying to a person sneezing while having a cold.

"When you become emotional, you cry. It's just like sneezing or coughing."

While sadness is a normal reaction, seek help from a primary care doctor if you experience lasting unhappiness or other signs of depression.